title: [The impact of guidelines for the management of acute cholecystitis in a rural area of Japan].
abstract: We monitored the management of acute cholecystitis in a rural area of Japan to determine the effectiveness of new guidelines for the management of acute cholecystitis and cholangitis. Between January 2000 and September 2011, 366 patients were treated for acute cholecystitis. Of these, 59 had common bile duct stones (CBDS) and 307 did not. Patients in both groups were further subdivided into two groups: a before guidelines group (BGG; n=153) and an after guideline group (AGG; n=154). Among the patients without CBDS, early cholecystectomy was more common in the AGG group (n=53) than in the BGG group. Furthermore, the length of hospital stay was four days shorter in the AGG group than in the BGG group (n=23). Among the patients with CBDS, the timing of cholecystectomy after endoscopic retrograde cholangiography was seven days earlier in the AGG group than in the BGG group. Even in a rural area of Japan, early cholecystectomy appears safe and can decrease the length of hospital stay.
authors.affiliation: Department of Internal Medicine, Tsuyama Central Hospital.
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Yamasaki
authors.forename: Ryuta
authors.initials: R
authors.lastname: Takenaka
authors.forename: Noriko
authors.initials: N
authors.lastname: Okazaki
authors.forename: Yuki
authors.initials: Y
authors.lastname: Baba
authors.forename: Kenta
authors.initials: K
authors.lastname: Hamada
authors.forename: Hiroki
authors.initials: H
authors.lastname: Takayama
authors.forename: Koji
authors.initials: K
authors.lastname: Takemoto
authors.forename: Akihiko
authors.initials: A
authors.lastname: Taira
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Tsugeno
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Kubota
authors.forename: Doufu
authors.initials: D
authors.lastname: Hayashi
authors.forename: Shigeatsu
authors.initials: S
authors.lastname: Fujiki
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002763:Cholecystectomy; D041881:Cholecystitis, Acute / Q000150:complications / Q000601:surgery*; D005260:Female; D042882:Gallstones / Q000150:complications; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D012423:Rural Health